Impairments of motor functioning are the most common deficits in children with cerebral palsy and other movement disorders. Therapeutic interventions for pediatric motor deficits are limited and often challenging. Effective intervention requires intensive, repetitive, and systematic motor training of body parts. However, conventional physical therapy is difficult to achieve high-intensity repetitive training in a short period of time and hard to get pediatric patients engaged in repetitive training. Various robotic devices have been developed and tested on adult and pediatric patients in recent years. Robot-assisted rehabilitation is using a robotic device to help the user perform a specific movement. The main goal of robot-assisted rehabilitation is to achieve numerous movements in limited time. Due to the intensity and repetition of movement, robotic assisted training therapy could have a beneficial effect on the recovery and improvement of motor deficits for children with cerebral palsy. Several studies tested the feasibility of applying robots in pediatric rehabilitation and showed that robot-assisted rehabilitation has a positive effect for children with cerebral palsy and other movement disorders.
Figure 1: A child during a robot-assisted rehabilitation session using the Amadeo® system.
Our research center is equipped with the latest innovation in robot-assisted rehabilitation for upper extremities. Amadeo® (Figure 1) is a sensor-based hand rehabilitation robotic device for patients with manual functioning impairments. It provides high-intensity, repetitive, task-specific, finger-specific, and interactive motor training for movements of individual fingers and thumbs. With interactive gaming, rehabilitation of finger function is not boring. By providing real-time feedback of metrics, such as force generated or range of motion, the system creates dynamic interaction between the participants and the system and gets participants more engaged in training. Besides movement therapies, the system also has functions to measure muscle tone, spasticity, strength, and range of motion. Precise quantification of these measures will be critical in assessing changes or improvements in motor functioning through repetitive training.
Our research center performs neuroimaging studies that focus on studying brain plasticity changes due to rehabilitation using various neuroimaging techniques for children with cerebral palsy and other movement disorders. Robot-assisted rehabilitation has been applied in stroke rehabilitation for adult patients and its effectiveness has been shown in several pilot studies. Yet, application of robot-assisted rehabilitation in pediatric cohorts is still limited but promising. Our research involves the application of upper extremities robot-assisted rehabilitation for the intensive motor training of children with cerebral palsy and the use of multi-modal brain imaging in order to assess whether intensive robot-assisted rehabilitation training could induce any functional or structural changes in the brain of children with cerebral palsy.